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Epidural Steroid Injections

Treatment Options

If conservative treatment options alone fail to provide the relief you’re seeking from back, neck, arm or leg pain, targeted epidural steroid injections (ESI) can often achieve effective results. ESIs are used to treat the following conditions:

Am I a Candidate for Epidural Steroid Injection?

Epidural steroid injections are most effective at treating pain in the following areas:

Before undergoing an ESI, you should pursue more conservative solutions such as:


Six weeks is often quoted as a reasonable timeframe to try these more conservative approaches before consideration of an ESI. However, in cases of severe or debilitating pain, or neurological signs or symptoms, an earlier ESI is reasonable and often very helpful.

During your initial consultation, your provider will review your medical history and imaging, and perform a physical examination. If we believe an ESI is the right treatment approach for you, we will discuss the procedure in detail so that you understand what is involved before moving forward.

It is important to note that while the ESI can provide pain relief, rehabilitation with physical therapy will still be necessary in most cases. You should be able to be more successful with your rehabilitation efforts while taking advantage of the pain relief provided by the ESI.

Clinical research has shown that ESIs can, in many cases, provide significant relief of pain on the order of weeks to months, or possibly more long-term. They can not only reduce the chances of needing surgery, ESIs also provide relief for enough time to allow you to progress through a rehabilitation program and improve your level of function.

If the ESI provides some duration of pain relief but symptoms return, a second injection may be considered in the following cases:

  • The first ESI provided significant, though partial, relief. The goal would be to eliminate the remaining pain
  • The first ESI provided substantial relief that lasted several days, weeks, or months and the pain begins to return

The decision to proceed with a second or third injection is made in consultation with your spine care provider. It is usual to wait two weeks or more between injections.

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The Epidural Steroid Injection Procedure

ESIs have been used since the 1950s for the treatment of back pain. Since that time, technology has improved, and currently the accepted method is to perform a targeted injection under fluoroscopic (X-ray) guidance. Before undergoing an ESI, you must complete the pre-injection process, which involves:

After this process has been completed, you will have your ESI scheduled. There are two types of ESIs used:

It can take between three days and two weeks for the steroid to reach maximum effect. After your injection we may also prescribe physical therapy to help you regain strength and function. You will return to our office four weeks after your injection so we can assess your response to the injection.

Other Treatment Options

If you do not experience significant relief from your ESI, it is important to follow up with your provider to discuss other treatment options. These may include:

In some cases, surgery may be the most appropriate option for you. Our team will perform all necessary diagnostic testing to provide your surgeon with the information necessary to plan your procedure.

Exceptional Pain Management Treatment

At the Denver Spine and Pain Institute, we have witnessed firsthand how debilitating pain can derail your quality of life. Our team is committed to providing you with the relief necessary to enjoy your favorite activities and perform routine daily activities with ease. Our goal is to help you live life to the fullest once again.

Our exclusive Connected Care Approach™ has been designed with your needs in mind, and it will get you back to enjoying life without the frustration and challenges that often come along with chronic pain. As part of this approach, you’ll receive:


  • A full spectrum of care options, including physician treatments, physical therapy, massage, diet and lifestyle coaching, behavioral health services and other state-of-the-art treatments
  • Individualized care plans to address your specific pain needs
  • Caring and therapeutic relationships with our team to ensure the best possible treatment
  • A detailed discussion of all your treatment options so that you can make an informed decision
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Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.

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